Present status and future prospects for malaria control in the world

The potential of residual insecticides with their direct action against the sporogonic cycle of plasmodia prompted the idea of possible eradication of malaria. In the early fifties health administrators supported by technicians favoured the control of endemic diseases through "mass campaigns". In such an atmosphere, at the 8th World Health Assembly held in Mexico in 1955 a resolution was adopted urging member states to initiate health programmes aimed at eradicating malaria. Initial spectacular results continued for ten years, but the progress slowed down considerably in the late sixties due to a number of technical, operational and administrative problems encountered in many countries. Nevertheless, malaria was eradicated in 37 countries and territories, thus freeing the population of some 500 million from the risk of infection. During the period 1972-1977 serious resurgence of malaria affected a number of countries in South East Asia, Central America and Turkey. Energetic counter measures have brought down malaria to a level which is far from being under control. At the same time in Africa, south of the Sahara, practically no organised control of malaria is being carried out. While malaria morbidity is rising, the policy of national health administrations is to carry out malaria control applying the strategy of Primary Health Care. However, in view of the multiple difficulties countries are facing much more flexibility and an epidemiological approach are required at this stage. Possible modalities for action are discussed in the paper in more detail.